Preventing Childhood Obesity – Eating Better, Moving More

Dr. John Iskander opens the CDC Public Health Grand Rounds for August 2018, expressing his pleasure in welcoming the audience. He introduces the continuing education aspect of the session and encourages viewers to send questions. Dr. Iskander mentions the 'Beyond the Data' video segment on YouTube and the CDC library's scientific articles related to the session. He also highlights upcoming Grand Rounds topics and acknowledges the contributions of listed individuals. Dr. Anne Schuchat is introduced as the CDC's principal deputy director and she addresses the audience, focusing on strategies to prevent childhood obesity by improving children's eating and physical activity habits.

Captain Heidi Blanck discusses the impact of childhood obesity on communities, explaining how BMI is used to assess weight status in children and adults. She presents data showing the increase in obesity prevalence among various age groups since 2000 and emphasizes the disparities in obesity rates related to race, ethnicity, and income. Blanck also addresses the misconception that children will outgrow obesity and presents data showing the progression of weight issues from kindergarten to adulthood. She explains the metabolic activity of adipose cells and the health risks associated with obesity, including heart disease, type 2 diabetes, and certain cancers.

The discussion continues with a focus on early weight gain in infants as a predictor of childhood obesity and the protective factors against it, such as breastfeeding and responsive feeding. The importance of a healthy diet, regular physical activity, and limiting sedentary behaviors for both adults and children is highlighted. Data graphics reveal that most US children do not meet the recommended amounts of healthy foods or physical activity. The presentation also addresses the high consumption of sugary beverages among children and the disparities in calorie intake from these beverages among different racial and ethnic groups.

Krista Scott from Child Care Aware emphasizes the role of early care and education settings in obesity prevention efforts. She outlines the different types of ECE settings and their impact on children's nutrition, physical activity, and development. Scott discusses the federal and state requirements for childcare, including the Child Care Development Block Grant (CCDBG) and its impact on low-income children. She also addresses the challenges faced by states in meeting these requirements and the need for guidance and support. Scott highlights the work of Child Care Aware of America in providing support to providers and states to ensure healthy childcare settings.

The conversation shifts to strategies for implementing healthier standards in out-of-school time settings. The National AfterSchool Association's physical activity and nutrition standards are mentioned, and the adoption of these standards by various organizations is discussed. The importance of leveraging electronic health records for local-level data collection and surveillance is also noted. The speakers acknowledge the need for more research and evaluation in this area, especially as it pertains to larger-scale interventions and the potential for reducing health disparities.

Sarah Sliwa from CDC Healthy Schools discusses the strategic role of schools in obesity prevention, given the amount of time children spend in schools. She highlights the importance of physical activity and nutrition for academic achievement and the whole-school, whole-community, whole-child framework for addressing obesity. Sliwa reviews the evidence supporting multicomponent, comprehensive approaches to improving student weight status and the CDC's School Health Guidelines for promoting physical activity and healthy eating. The need for ongoing research to identify effective strategies, especially at the high school level, is emphasized, as well as the importance of understanding the long-term impacts and sustainability of these interventions.

Mikki Duran shares insights from the Appleton School District in Wisconsin, emphasizing the importance of connecting health with academic success to gain school administrators' attention. She discusses the use of data to support health initiatives and the implementation of a physical activity program to improve student health and learning. Duran also talks about the district's efforts to increase activity time during the school day and the positive outcomes of using wellness rooms to help students with physical aggression. The role of school wellness policies and the Whole School Child Model in guiding school districts is highlighted, along with the importance of involving the entire school community in health efforts.

The session concludes with a Q&A segment where the panelists address questions from the audience and online viewers. Topics discussed include strategies for getting teachers to adopt healthy habits, the structure of wellness rooms, the importance of teacher health, and the challenges of implementing health policies in schools. The panelists also discuss high-priority scientific gaps and areas for future research, such as understanding optimal infant nutrition, the impact of social determinants on health, and the need for process and implementation science to enhance the adoption and effectiveness of evidence-based interventions.